Toxic smog threatens millions of Chinese lives

One of China's leading lung specialists says Beijing must act fast to save
lives by closing polluting factories and improving fuel quality

View of a high-rise building in heavy smog in Jilin city, northeast Chinas Jilin provincePhoto: Corbis

Tom Phillips in Shanghai

8:29PM GMT 18 Feb 2014

Millions of lives will be unnecessarily lost to soaring rates of respiratory disease and lung cancer unless the Chinese government takes determined action against rampant air pollution, according to one of the country's foremost lung experts.

Bai Chunxue, the head of respiratory medicine at Shanghai's Zhongshan Hospital, said that while smoking was still the main culprit for skyrocketing rates of lung cancer and chronic obstructive pulmonary disease (COPD), the dangerously high level of air pollution was taking an increasingly devastating toll on Chinese lungs.

"If air pollution is not reduced we will have more and more respiratory disease, including lung cancer, COPD, asthma and even pneumonia and also heart disease, coronary heart disease," warned Dr Bai, who is also chairman of the Chinese Alliance against Lung Cancer and the director and founder of the Shanghai Respiratory Research Institute.

He singled out the level of fine dust particles with a diameter of 2.5 micrometres or less - known as PM2.5 - as especially dangerous because of their impact on both respiratory and cardiovascular systems.

"Respiratory disease, including lung cancer, causes a very high incidence of mortality," he said. "Therefore, if they [authorities] pay more attention to prevention and treatment we can save a lot of lives - not only of Chinese patients but of foreigners, because air pollution is not just causing a problem for China. It can move to Japan, to America, anywhere."

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Dr Bai's comments to The Telegraph came as state media took the unusual step this week of lampooning the Chinese government for failing to protest its citizens from toxic air.

"Don't pretend to be blind to the smog," CCTV, the state broadcaster, urged on Weibo, the Twitter-like social media platform, after Beijing's air quality plummeted to "hazardous" depths over the weekend but authorities failed to take emergency measures. "The government should not shun its responsibility or turn a blind eye to the smog."

The English-language China Daily also slammed Chinese politicians for their "indefensible" response to a recent wave of air pollution.

"Beijing government leaders and leaders of other cities have time and again expressed their resolve to tackle the problem of air pollution," it said. "But their inaction in the face of the heaviest air pollution in a month flies in face of their own promises and their own credibility."

Dr Bai, whose hospital is part of Shanghai's prestigious Fudan University, told The Telegraph he believed Communist Party leaders now understood they had to act. "They are also afraid of air pollution," he said. He called for tougher fuel standards for vehicles and the closure or relocation of polluting factories.

Among a flurry of official announcements over recent days about anti-pollution initiatives has been a plan to create a 10 billion yuan (£9.8 billion) "reward" scheme for cities that succeed in significantly reducing pollution. A 22-point nationwide "clean air plan" is expected to be submitted to the state council, China's cabinet, soon.

Air pollution is also likely to be a major talking point among leaders and advisers at next month's National People's Congress in Beijing.

Dr Bai, whose 40-strong medical team treats around 150,000 lung patients each year, said he feared that even with concerted action, "we will still have this problem in around 10 or 20 years."

Until then, he is taking precautions of his own. On smoggy days, the veteran doctor wears a face mask during his walk of just over a mile to work. Hoping to escape the fumes, he has also moved to a 37th floor flat. "It's the top one in my building. Air pollution is usually highest at the level between the 10th and the 20th floors."

China diagnoses around 1.3 million new cases of chronic bronchitis and emphysema each year, and around 600,000 new cases of lung cancer. Over the last 30 years deaths ascribed to lung cancer have risen by a factor of five in China, an increase that Dr Bai attributes to a combination of better diagnostic techniques and rising levels of pollution.

Dr Bai said tobacco was still by far the leading "risk factor" associated with both conditions, but was followed by "really serious" air pollution. Last December, during a particularly severe bout of smog, the number of outpatients at his Shanghai clinic rose by almost a third.

Rising lung cancer rates among non-smoking women and the young also suggested pollution was an increasingly important risk factor, Dr Bai added. Last November, an eight-year-old girl in Jiangsu province was diagnosed as China's youngest lung cancer sufferer, with her doctor blaming air pollution.

Dr Bai said he suspected pollution had also contributed to the lung cancer he diagnosed in his own youngest patient, a 14-year-old girl.

"To see older people suffering from lung cancer is not strange," he said. "But for a girl who is only 14-years-old, it is very awful."

Despite a dearth of academic research on the topic in China, there is an increasing consensus about the connection between familiar grey skies over Chinese cites and the black lungs of their inhabitants.

Air pollution causes between 350,000 and 500,000 premature deaths each year, Chen Zhu, China's former health minister, estimated in the Lancet medical journal in December.